Abstract: Objective:To investigate the clinical efficacy and safety of Huangqi Dihuang decoction combined with cyclophosphamide in the treatment of refractory nephrotic syndrome.Methods:Ninety-six patients with refractory nephrotic syndrome were randomly divided into the observation group and control group(48 cases each group).The control group was treated with cyclophosphamide,and the observation group was treated with Huangqi Dihuang decoction based on the control group for 6 months.The effective rate of treatment,levels of urea nitrogen(BUN),serum creatinine(Scr),24 h urinary protein,interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) before and after treatment,and adverse reactions between the two groups were compared.Results:The total effective rate in observation group(95.83%) was higher than that in control group(79.17%)(P<0.05).Compared with before treatment,the levels of BUN and Scr,24 h urine protein,IL-6 and TNF-α in two groups significantly decreased after treatment (P<0.01),and the decreasing levels of BUN and Scr,24 h urine protein,IL-6 and TNF-α in observation group were significantly lower than those in control group(P<0.01).No obvious adverse drug reactions in two groups were found.Conclusions:Huangqi Dihuang decoction combined with cyclophosphamide in the treatment of refractory nephrotic syndrome is effective and safe,which may be related to the improvement of renal function and decreasing levels of 24 h urinary protein,IL-6 and TNF-α.